> 1.If you are(or are thinking of going )paperless,what do you do if you
> need a locum - especially one not conversant either with your system or
> with the way you use your system?

Some practices I've seen ask the locum to record on paper, then someone
else transcribes it into the computer. Not ideal, but if the information
has to be recorded 'your' way, I see no other option.

> 2.If you are a locum(either temporary or permanently and proffesionally)
> is it either reasonable or practcal to expect you to be able or willing
> to enter all your consultations on the practice computer - asssuming
> that every system is diffferent - and usage of the same systems is
> probably very different as well?
> (are there any locums on GP-UK? *please* either reply or email me
> privately.. thgis problem must concern you..)

You could try this, but I suspect that you might reduce your dwindling
pool of locums even further. Further, I for one would be quite concerned
about such a requirement: I have no control over what you choose to do
with the computer record after I have gone. I have no way of knowing
how secure your system is, or how carefully you look after the information
it contains. I prefer to use the paper-based record in locum land, because
the legal situation surrounding them is at least well understood.

> 3.If you are dependant on your computer - paperless or linked - what do
> you do about IOS claims and statistics etc if you have a locum?

At the end of the day it is inevitably the case that all doctors will
record things differently (if at all!). When we all used to scribble
our own notes on bits of paper, and nobody bothered really to try and
analyse the collective set of notes, it wasn't a problem. Computers
offer the chance to do the analysis much more quickly than wading through
piles of Lloyd-George folders, but any analysis will be more or less
suspect depending on how consistent the computer record is between users -
both in the rate at which they record, and the degree to which they agree
on how to use the terminology.

I don't see how you can expect itinerant locums to be familiar with all
the systems they might encounter. Even if they were, it is unlikely that
they could mimic how you actually use it. If you want that degree of
familiarity with your particular practice system and style, then you will
need to try to cultivate 'regular' locums and pay to train them in your
particular view of the world. Similarly, if you are employing a locum
for a longer period of time - a week or more - then you might consider
a more formal training in your system than the five minutes on day one
from one of the practice staff which seems to be the norm. Since most
locums are doctors recently off the VTS, you will need to repeat this
training regularly.

As an aside, practices which are in the habit of employing itinerant locums
at very short notice, then giving them a surgery of 24 five minute, late
booked appointments (most of whom will be acutes) plus five extras can not
really be suprised if the locum chooses not to bother wrestling with the
practice computer.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Dr Jeremy Rogers MRCGP DRCOG DFFP MBChB
Clinical Research Fellow and itinerant locum
Medical Informatics Group
Department of Computer Science
Manchester University, Oxford Road
Manchester, United Kingdom
M13 9PL

(+44) 161 275 6145 voice
(+44) 161 275 6932 fax
[log in to unmask]
URL http://www.cs.man.ac.uk/mig/people/jeremy.html
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